Islet Cell Tumor of the Pancreas: Biphasic CT versus MR Imaging in Tumor Detection

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Abstract
To compare the effectiveness of biphasic computed tomography (CT) and magnetic resonance (MR) imaging in the detection of pancreatic islet cell tumors. Retrospective quantitative, qualitative, and receiver operating characteristic analyses of biphasic CT and MR imaging were performed in 19 patients with 26 histopathologically proved islet cell tumors. Delayed arterial dominant-phase (AP) and portal venous-phase (PVP) biphasic CT was performed after the administration of contrast material. MR imaging included T1-weighted spin-echo (SE) and T2-weighted SE or fast SE imaging, fat-saturated T1-weighted SE imaging, dynamic contrast material-enhanced T1-weighted gradient-echo imaging, and delayed enhanced T1-weighted SE imaging with or without fat saturation. PVP CT and delayed enhanced T1-weighted MR imaging had the highest A(z) values (0.98 and 0.97, respectively; P <.05). Delayed enhanced T1-weighted MR imaging had the highest relative sensitivity (14-15 [74%-79%] of 19 lesions), followed by PVP CT (18-19 [69%-73%] of 26 lesions), AP CT (17-19 [65%-73%] of 26 lesions), fat-saturated T1-weighted MR imaging (eight to 10 [57%-71%] of 14 lesions), T2-weighted (16-17 [62%-65%] of 26 lesions), T1-weighted (15-18 [58%-69%] of 26 lesions) MR imaging, and dynamic MR imaging (nine [56%] of 16 lesions). Biphasic (especially PVP) CT and MR imaging have similar effectiveness in the detection of islet cell tumors if fat-saturated T1-weighted and delayed enhanced T1-weighted MR imaging are included.